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The QPA was awarded to the Practice in December 2002 . The award had taken nearly 3 years of hard work , involving all the members of the Health Centre, in creating the necessary documentation. Our Health Centre is the second in Devon, and the 42nd in England, to have attained the award, which was the idea of Dr Nick Read. The documentation was compliled electronically on a CD by Dr Ross Dell, instead of using the normal paper format, which would have required 6 lever arch files of data. The Practice was then inspected for a full day, by 4 assessors who met all the staff and questioned members of the team to satisfy themselves that the Practice had reached the required standard for the award.
The criteria for the award encompassed all aspects of care in the Health Centre from administration , health and safety, to extensive assessment of guidelines and protocols. There has been a very noticeable change in the team atmosphere in working for the award where all staff have worked together for a common purpose and this will hopefully be reflected in enhanced clinical care.
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Job Share Partner Vacancy Sidmouth, East Devon
Enthusiastic job share partner required to join current full time female partner wishing to reduce to part time. Superb location on East Devon's' Jurassic coast in an area of outstanding natural beauty, 18 miles from Exeter.
4th Wave PMS pilot practice meeting all quality markers and targets and recently gained the RCGP Quality Practice Award in December 02, the 2nd practice in Devon so far to achieve this. We are a forward thinking, progressive, supportive, very friendly and committed primary health care team aiming to provide high quality care to all our patients and staff.
7 full time partners (6 male + 1 female wishing to reduce to p/t), with 1 salaried PMS GP + 1 p/t female assistant. We run strict personal lists approx 2000 patients each and have dedicated Nurse led clinics for CHD, Asthma, Diabetes, Hypertension and Travel advice and immunisation. Above average earnings. Two premises rented Health centre (planning to redevelop) and owned modern branch surgery.
GP community Hospital with 26 beds next door to Health Centre. Visiting local consultant outpatient clinics and operating theatre sessions on site. Minor Injuries unit/casualty covered by GPs, with access to X-ray, physio, OT and reablement team based in the community hospital
Practice rota 1 in 14 (p/t equivalent) 7am-7pm + local Out of Hours Co-operative, but sessions easily sold if required. Fully computerised, Protechnic Exeter systems, Practice Intranet + Path Lab links + direct desk top internet + NHS net access.
We are looking to appoint an enthusiastic, caring and committed job share partner with a good sense of humour, a genuine interest in geriatric medicine and eligible for CHS, Minor ops and Obstetric lists, to fit into our very democratic and supportive team. Golden Hello may be available if all criteria are met.
Start date 1st July 03. Informal enquiries by phone or email to Dr Joanna Kinder tel 01395 516162 or email tim@core-hill.freeserve.co.uk Practice profile available or view practice web site at www.siddoc.co.uk for more information. Please apply with letter. CV and references to Mr Rob Spargo, Practice Manager, Sid Valley Practice, Sidmouth Health Centre, Sidmouth Devon EX10 8ET , tel no 01395 512601. Closing date for applications 15.4.03 Interviews April/ May 03.
Practice Profile for Job Share Partner at Sid Valley Practice
Partners
At present there are 7 full time partners, 6 male + 1 female.
Dr Andy Ridler, Dr Ed Morris, Dr Mike Slot, Dr Duncan Hall, Dr Nick Read, Dr Jo Kinder and Dr Ross Dell.
Dr Jo Kinder has worked as a full time GP in the practice for 7.5 years and now wishes to reduce to part time, due to family commitments.
We have a salaried PMS GP working 4 days a week, Dr Peter Fung who has recently retired from full time general practice in Southampton and a female assistant GP, Dr Fiona Crooker working 2 days a week.
The partners all work 9 sessions per week, Monday to Friday. We have 1 half day per week, 1 administration session and 8 clinical sessions. Our duty rota, as FTE partner is: 1 in 7 weekdays on call, currently from 7am to 7pm, the co-op covering the out of hours. We also cover 1 in 7 weekends as" first on" duty, with a "second on" GP working the Saturday morning surgery 9am to 11am, plus shared visits, to help the "first on" GP. This works out as 2 Saturday mornings in 7. As a part time job share partner the rota would become 1 in 14 on call on week days + 1in 14 weekends, with 2 Saturday mornings in 14.
Each partner has separate clinical and a managerial roles, covering different areas of interest within the practice. We feel we have a very democratic, open, friendly and mutually supportive partnership. We are all strongly committed to providing high quality care to our patients. We enjoy being family doctors and run strict personal lists. We each have approx 2000 patients.
We aim to have one practice meeting per week held at lunchtimes, to discuss practice business issues. We have clinical meetings and our aim is to do this on a 1 per month basis, incorporating SEA. We have a practice Away Day 1 x per year. We have a partnership agreement which has recently been thoroughly debated and agreed. We have tried to have partners meetings on a quarterly basis.
Primary Health Care Team
The practice is based on two sites. The main health centre is in Sidmouth and is rented from the PCT. The Branch Surgery in Sidford is a modern surgery, built 10 years ago and is owned jointly by all 7 partners.
We are extremely proud of our very friendly, hard working and committed primary care team. Over the last 3 years we have become a very united, dedicated and happy team, as we worked towards the Quality Practice Award and became a 4th wave PMS practice in October 2002.
Our practice was awarded the QPA in December 2002 and we are the 2nd practice in Devon to achieve this voluntary award from the RCGP. We are meeting all are quality markers and targets set by our own PMS contract
Community Hospital
As partners we are employed as Clinical Assistants by the Community Hospital to provide casualty/ minor injuries cover and in patient care for our practice population.
PMS 4th Wave pilot
QPA
Practice population + interests+ management
Practice Rota
Out of Hours Co-operative
Location
Area
Sports + Leisure facilities
Family
Sidford Flat
Education
Income
Golden Hello ?
Norwalk virus is
one of the commonest causes of viral gastroenteritsis and has in the past
been under reported. It is most notable for it's winter time outbreaks
although can occur at any time of year. The virus is particularly a
problem in institutions like hospitals, hotels and cruise ships.
The Norwalk is an RNA viruses , and is member of a group of viruses called small round virus. Norwalk was the first Small Round Viruses to be described, but similar viruses have now been found in outbreaks in many areas, notably in Hawaii and Montgomery County, Maryland. In the United Kingdom the species are named after Southampton, Taunton, Bristol, and Lordsdalethe commonest species in the United Kingdom, further afield is the Desert Storm species. Though morphologically indistinguishable from Norwalk, further antigenic typing has been prevented by difficulty in obtaining sufficient purified virus and by SRSVs' failure to grow in cell cultures. No animal strains have been described.
Humans are the only known hosts of Norwalk-like viruses. Infection can be acquired through consuming contaminated food or water, or more commonly from an infected person via the faeco-oral route, through vomit, or by aerosol spread, particularly when a patient vomits. Food borne transmission is often due to poor hygiene in the kitchen, but filter feeding bivalve molluscs harvested from water polluted by sewage also pose a threat, most notably oysters.
The incubation period varies from 10 to 70 hours but is usually 24-48 hours. Symptoms include nausea, vomiting (often projectile), diarrhoea, and stomach cramps. Vomiting and diarrhoea can occur with little or no warning. Patients may also suffer headache, fever, chills, and muscle aches. The illness usually resolves within 24-48 hours, but may last a week or longer. There is no specific treatment and no long term effects. Patients with diarrhoea or vomiting should drink plenty of liquids to prevent dehydration.
Norwalk-like viruses can cause illness at any age, possibly due to their antigenic diversity but also because infection appears to induce only short term immunity. Other enteric viruses such as rotaviruses, astroviruses, which have also been associated with foodborne outbreaks, generally result in long term immunity which is acquired during childhood.
Normally the infection is cleared in 12-36 hrs without serious complication.
Prevention of spread.
Scrupulous hand washing is essential.
Any food handlers or carers should avoid contact with patients until 48 hours after symptoms have resolved.
Disinfection of the areas contaminated with vomit and faeces using bleach solution.
References
BMJ 2002; 324: 249-250 John M Cowden, consultant epidemiologist.
BMJ 1999; 318: 1433-1434 Antony Hale, Senior registrar in virology.
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Meningitis is an infection of the meninges, or lining of the brain, normally either a virus or bacteria. It is the latter group of bacteria that are particularly serious of which there are three main groups; the pneumoccal infection related to chest infections, the haemophilus influenza particularly in children and the meningococcal bacteria occurring in toddlers and in cluster cases in adolesants which is probably the most serious.
In meningococcal disease at least half the cases present with a generalised septicaemia and rash without the characteristic neck stiffness of meningitis. This is particularly serious.
Meningitis has the following characteristics -
Headache and a fever,
Stiff painful neck
General malaise [ illness ] often accompanied with vomiting and photophobia (avoidance of light)
A purple blackish rash that appears rapidly on the body and does not disappear with pressing it with a glass.
Meningococcal meningitis occurs in the toddler group and also in late teenagers, particularly in institutions. It is not uncommon to harbour this bacteria in the upper nose although only a few cases will result in meningitis. Meningococcal Group C infection accounts for 40% of all cases of meningococcal disease. The majority of the remainder are Group B. In England and Wales the annual estimate of this disease is 1530 of which there were 150 deaths of Group C disease.
VACCINATION
A new vaccine is available for meningococcal C disease which stimulates the body's own immune system to produce antibodies against this potential bacteria.
It is planned that this immunisation with Meningococcal Group C Conjugate vaccine will start in the Autumn 1999 and will occur in various phases.
Phase 1-Autumn 1999
Babies 2, 3 and 4 months given with baby immunisations.
Children of 13 months will be given one dose with their MMR.
Babies 4 months to 1 year two doses of the vaccine.
Phase 2 - January 2000
The remainder of all children.
By all accounts this is a very effective and safe vaccine.
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E. Coli 0157 is carried particularly by cattle and can be transferred to humans via direct contact with animals, their faeces or through contaminated foods including meat, unpasturised milk and vegetables contaminated with manure. It may also be transmitted by waterborne infection.
The incubation period is between three to eight days (normally three to four days) with symptoms ranging from mild non-blood diarrhoea to severe blood-stained diarrhoea. Up to 7% of cases develop haemolytic uraemic syndrome (acute kidney failure).Since August of this year there have been at least six cases of E.Coli 0157 in the South Hams[ South Devon ] district though it is unclear as to the exact source of the infection.
It is very important that all cases of blood-stained diarrhoea are investigated rapidly with this in mind .
Samples of the faeces must be sent for assessment so that early antibiotic treatment can prevent this illness.
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At last the government seems to have started to address the need to encourage patient's to stop smoking. Smoking is the commonest preventable cause of death in the western world, with half of all those patient's dying prematurely of the habit .
Despite this over 30% of the population smoke but virtually all wish to give up. The problem, is that nicotine is as addictive, a drug as heroine , and so few succeed ; those that do too frequently become tempted back , by just that one cigarette, and the habit is re-kindled.
Many method's have been tried to kick the habit including , hypnotherapy , acupuncture , counselling , but perhaps the best methods revolve around medication. Until recently this was with NRT ( Nicotine Replacement Therapy ) , but more recently this has been with Zyban ( Bupropion ) .
NRT Work by substituting the nicotine in cigarettes with a replacement dose, with the aim of negating the physical craving of the cigarettes . Various methods have been tried which include chewing-gum, inhalers and patches , although the route probably doesn't matter. Generally these are used for three months starting with cessation of the smoking at the commencement of NRT. From 15/5/01 these have been available of an NHS FP1001 prescription .
The other recent method is Zyban (Bupropion ) This was first produced 20 yrs ago as an anti-depressant , but it is only relatively recently that this has been re-licensed for it's use in smoking cessation .
Zyban has had recent adverse press, which is probably unjustified. Although there have been a number of deaths of patient's taking the drug, this does not necessarily mean that Zyban has been the cause. There is however a risk of epileptic fits in the order of 1:1000 , which is actually the same for patient's taking any anti-depressant. It is therefore advisable that patient's do not take zyban if there is a history of epilepsy, head-injury, diabetes or heavy drinking. In addition drug interactions that prohibit the co-precribing of zyban include anti-malarials, anti-histamines , "mental illness " drugs , theophyllines , steroids, some anti-biotics , analgesics like tramadol, and slimming medication.
Despite this Zyban is twice as effective , as assessed by the number of patient's who have given smoking and remained non-smokers at a year , than NRT ( 19 % v 9 % ), it's also marginally cheaper .
For further support ring the anti-smoking help-line 01392 207462
NHS STOP SMOKING Web Site
NHS
HELP-LINE
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